To the best of our knowledge, we might hypothesize that low B3 levels are frequent in the elderly, and this may influence the development of small vessel disease and subcortical vascular dementia, switching ECs towards a procoagulant state, increasing plaque deposition, reducing Sirt1 expression, and promoting senescence mechanisms, such as apoptosis, neuroinflammation (through Sirt1 and PARP, 200, 242, 243), ECs, and neuronal death. Here, SIRT1 is linked to vascular dementia.